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Dr. Bob is Robert Hsiung, MD,
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Posted by samantha28 on April 17, 2009, at 18:25:09
Hi, while DSM states you can only have a mixed episode in bipolar I and not in bipolar II many clinicians seem to diagnose people with bipolar II - mixed state.
Yet many MH professionals say you can have mixed state in bipolar II as well:
Bipolar I - mixed state looks like this:
"A dysphoric mania consists of a manic episode with depressive symptoms. Increased energy and some form of anger, from irritability to full blown rage, are the most common symptoms (MMDT). Symptoms may also include auditory hallucinations, confusion, insomnia, persecutory delusions, racing thoughts, restlessness, and suicidal ideation."
Bipolar II - mixed state looks like this:
"An agitated depression is a "major depressive [episode] with superimposed hypomanic symptoms" (Benazzi, 2000). Mixed episodes in which major depression is the primary state, concurrent with atypical manic features were described in two studies (Benazzi & Akiskal, 2001; Perugi et al., 2001). A study by Goodwin and Ghaemi (2003) reported manic symptoms in two-thirds of patients with agitated depression, which they suggest calling "mixed-state agitated depression".
This sounds like hair splitting splitting. Agitated depression sounds like dysphoric mania to me.
I have the following symptoms: intense suicidal urges, irritability, high sex drive, feeling fat but energized with nervous energy, depressed mood but I can change to euphoria for brief moments, tired at the same time as being energized, racing thoughts, lack of ability to concentrate and I feel like I need to be moving all the time despite feeling fatigued, negative remunerations, sometimes I can feel like I can do anything and other times I feel hopeless and pensive and empty.
I have been dx as bipolar I mixed state by one doctor and bipolar II mixed state by another - which is the more correct dx?
cheers
Samantha
Posted by TexasChic on April 17, 2009, at 22:37:38
In reply to Mixed state - bipolar I or II, posted by samantha28 on April 17, 2009, at 18:25:09
You might try posting this on the psychology board, they are good at this type of discussion.
http://www.dr-bob.org/babble/psycho/
-T
Posted by Kath on April 18, 2009, at 21:10:05
In reply to Mixed state - bipolar I or II, posted by samantha28 on April 17, 2009, at 18:25:09
I agree with TC regarding the questions you're wondering about.
Nice to see you here & maybe you might decide to hang around Social also & 'get to know' us.
:-) Kath
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